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Urinary Incontinence: Market Update - Growing Market Brings Opportunities for New Drugs


Description: Introduction Urinary incontinence can be defined as ‘the involuntary loss of urine which is objectively demonstrable and a social or hygienic problem’. Within this broad definition, urinary incontinence in adults can be further classified into four main types of incontinence based on the symptoms experienced at presentation and the physiological characteristics associated with the disease. These four main types of incontinence are: overflow incontinence, stress urinary incontinence, urge incontinence and mixed incontinence. Partly in a bid to increase the number and type of patients with incontinence eligible for clinical trials, the FDA has adopted an alternative term, 'overactive bladder', to describe a syndrome that encompasses not only urge incontinence, but also urgency, frequency, dysuria and nocturia. Detrol, Ditropan XL and Detrol LA are all approved in the US and Europe for the treatment of overactive bladder (OAB). Pfizer’s aggressive marketing activity to support the launch of Detrol (tolterodine) also successfully raised wider disease awareness. With the two market leading drugs both suffering from poor side-effect profiles, and considerable scope for improved efficacy, there is still considerable unmet need in the market. Scope - Overview of epidemiology of urinary incontinence, by sub-indications, with an evaluation of the potential for expanding the diagnosed population - Review of the performance of the leading drugs in the market, Pfizer’s Detrol (tolterodine) and ALZA’s Ditropan XL (oxybutynin chloride) - Analysis of the potential of Yamanouchi’s Vesicare (solifenacin succinate), Novartis’s Enablex (darifenacin) and Eli Lilly’s duloxetine Report Highlights - Fighting off strong competition from Yamanouchi’s Vesicare and Enablex from Novartis, Pfizer’s Detrol will maintain its position as urinary incontinence market leader. - Of the two drugs expected to launch in 2004, Vesicare is expected to prove more popular than Enablex, backed up by favorable results from a head-to-head study with Detrol. Thanks in part to this, its sales will surge to $971m by 2011 while Enablex will reach $743m. - In the stress urinary incontinence sub-indication, Eli Lilly’s duloxetine will enjoy considerable success as the market expands, with sales of $488m forecast for 2011. Reasons to Purchase - Gauge the potential of the key late-stage pipeline products - Understand the factors driving the urinary incontinence market - Evaluate the patient potential in each of the key urinary incontinence sub-indications


Contents: Table of contents EXECUTIVE SUMMARY - Introduction - Scope and coverage of the Market Brief - Key findings about the the topic EPIDEMIOLOGY - Definition Urge incontinence - Urge incontinence vs. overactive bladder Stress incontinence Mixed incontinence Overflow incontinence - Patient potential Segmentation by type of urinary incontinence Overactive bladder - Diagnosis - Diagnosis rate - But is there a need for drug treatment? Pharmacological management of SUI - Alpha-adrenergic drugs - Tricyclic antidepressants Pharmacological management of urge incontinence - Anticholinergic agents - Detrol still number one, despite launch of Ditropan XL OPPORTUNITIES FOR PHARMA - Pharmacological therapies with improved clinical profiles - Effective drug treatments for stress incontinence THE CURRENT MARKET - Detrol (tolterodine) - Current market position - Future growth - Ditropan XL (oxybutynin chloride) - Opportunities for pipeline products PIPELINE POTENTIAL - Pipeline overview - Vesicare (solifenacin succinate) Marketing Clinical trials - Comparison with Detrol - Enablex (darifenacin) Clinical trials - Duloxetine Marketing Clinical trials Market potential Duloxetine forecasts - Diagnosis and drug-treatment rates MARKET FORECASTS APPENDIX - Bibliography Disclaimer TABLES Table 1: Urinary incontinence population in the seven major markets (million), 2002-10 Table 2: Segmentation by type of urinary incontinence Table 3: Overactive bladder population in the seven major markets (million), 2002 Table 4: Urinary incontinence: mid to late-stage pipeline, 2003 Table 5: Comparison of efficacy of Vesicare and Detrol, mean change from baseline to endpoint (episodes/24-hour period) Table 6: US potential SUI market (million), 2004-11 FIGURES Figure 1: The four types of urinary incontinence Figure 2: Global urinary incontinence drug sales forecasts ($m), 2002-11




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